Cardiopulmonary Evaluation and Airway Management

Flashcards related to the key concepts of airway management.

What are the reasons for suctioning?

• Retained secretions

• foreign bodies

• edema

• tumors

• trauma related

What are two techniques for endotracheal suctioning?

Open and closed

What equipment is needed for suctioning?

Vacuum source, regulator, collection bottle, connecting tubing, gloves, sterile suction catheter, sterile water, goggles, mask, O2 source, pulse oximeter, manual resuscitation bag, stethoscope

What are the complications and adverse responses of endotracheal suctioning?

• Hypoxemia,

• cardiac dysrhythmias,

• hypotension/hypertension,

• atelectasis,

• mucosal trauma,

• increased ICP,

• bacterial colonization

Why is sputum collected?

Identify organisms affecting the airway

What are the routes for establishing an artificial airway?

Pharyngeal airways and endotracheal tubes

What are the procedures for establishing an artificial airway?

Orotracheal, nasotracheal, and tracheotomy

What are the two basic types of tracheal airways?

Endotracheal tubes and tracheostomy tubes

What are the steps involved in endotracheal intubation?

Assemble and check equipment; position patient; preoxygenate and ventilate patient; insert laryngoscope; visualize glottis; displace epiglottis; insert tube; assess tube position; stabilize tube/confirm placement

What are the most common laryngeal lesions associated with tracheal tubes?

Glottic edema, vocal cord inflammation, laryngeal/vocal cord ulcerations, vocal cord polyps or granulomas, vocal cord paralysis and stenosis

What are the tracheal lesions associated with tracheal tubes?

• Granulomas,

• tracheomalacia,

• tracheal stenosis,

• tracheoesophageal

• tracheoinnominate artery fistula

How can airway trauma associated with tracheal tubes be prevented?

Sedation, Swivel adapter, correct airway size, maintain pressures of 20-30 cm H2O

What is the role of RTs in airway maintenance?

Secure tube, maintain placement, provide for patient communication, ensure adequate humidification, minimize nosocomial infection, facilitate secretion clearance, provide appropriate cuff care, troubleshoot airway-related problems

What are the steps involved in tracheostomy care?

Assemble equipment, explain procedure, suction patient, remove and clean inner cannula, clean stoma site, change ties/holder, replace inner cannula, reassess patient

What can cause tube obstruction?

• Kinking or biting tube,

• herniation of cuff,

• Obstruction of tube orifice,

• Mucus plugging

How to treat a ruptured cuff?

Extubation and reintubation or using endotracheal tube exchanger

What indicates accidental extubation?

Decreased breath sounds, decreased airflow through tube, decreased ability to pass catheter, air through mouth and nose or into stomach

How to assess patient readiness for extubation or decannulation?

Original problem is no longer present, secretion quantity/thickness, upper airway patency, gag reflex, ability to clear secretions

What are the steps of extubation?

Assemble equipment, suction tube and pharynx, oxygenate patient, deflate cuff, remove tube, apply oxygen and humidity, assess patient